Emergency and Disaster Reports
ISSN 2340-9932 Vol 1, Num 2, 2014
Monographic issue The Mass Influx of Syrian Refugees to Turkey
Merve Ay
University of Oviedo – Department of Medicine
Unit for Research in Emergency and Disaster
Emergency and Disaster Reports 2014; 1 (2): 2-53
Letter from the editors
The Emergency and Disaster Reports is a journal edited by the Unit for Research in Emergency and Disaster of the Department of Medicine of the University of Oviedo aimed to introduce research papers, monographic reviews and technical reports related to the fields of Medicine and Public Health in the contexts of emergency and disaster. Both situations are events that can deeply affect the health, the economy, the environment and the development of the affected populations.
The topics covered by the journal include a wide range of issues related to the different dimensions of the phenomena of emergency and disaster, ranging from the study of the risk factors, patterns of frequency and distribution, characteristics, impacts, prevention, preparedness, mitigation, response, humanitarian aid, standards of intervention, operative research, recovery, rehabilitation, resilience and policies, strategies and actions to address these phenomena from a risk reduction approach. In the last thirty years has been substantial progress in the above mentioned areas in part thanks to a better scientific knowledge of the subject. The aim of the journal is to contribute to this progress facilitating the dissemination of the results of research in this field.
Turkey has been a country of mass influx throughout its history due to its geographical location, political stability in the region, and ethnic relationship across the borders with its neighbors. Turkey lastly have become the destination for the Syrians fleeing the civil war in their country. This report seeks to summarize the response of Turkey to the mass influx crisis from Syria, which began on April 2011, and continues today with the number of registered refugees reaching 516,206 as of November 15, 2013.
Prof. Pedro Arcos, Prof. Rafael Castro Editors, Emergency and Disaster Reports
Unit for Research in Emergency and Disaster Department of Medicine. University of Oviedo Campus del Cristo 33006 Oviedo – Spain www.uniovi.net/uied
1 Emergency and Disaster Reports 2014; 1 (2): 2-53
Monographic issue
The Mass Influx of Syrian refugees to Turkey Author: Merve Ay
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Table of Contents
1. Introduction ...... 3 2. History of the Mass Influx ……………………………………………....3 2.1. Immigration of Turks from Balkans ...... 5 2.2. Temporary Displacement of Populations ...... 6 3. The Legal Aspects related to Mass Influx ...... 8 4. The Syrian Conflict ...... 10 5. The Refugees ...... 11 5.1. Displacement into Camps ...... 13 5.1.1. Status and Protection ...... 15 5.1.2. Shelter and NFIs ...... 18 5.1.3. Food ...... 20 5.1.4. Water and Sanitation ...... 21 5.1.5. Health ...... 23 5.1.6. Education ...... 25 5.2. Urban Refugees ...... 26 5.2.1. Status and Protection ...... 28 5.2.2. Livelihood ...... 29 5.2.3. Shelter and NFIs ...... 31 5.2.4. Food ...... 32 5.2.5. Health ...... 33 5.2.6. Education ...... 35 5.3. IDPs in the Northern Syria ...... 36 6. Effects on the host communities ...... 39 7. Different Actors and Relationships ...... 41 8. Conclusions ...... 42 Bibliography ...... 43
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1. Introduction
The United Nations High Commissioner for Refugees (UNHCR) defines mass influx as "situations involving the arrival across an international border of persons in need of international protection in such numbers and at such a rate as to make individual determination of their asylum claims under national procedures impracticable (bearing in mind available resources)" (UNHCR, 2009).
The International Federation of Red Cross and Red Crescent Societies (IFRC) classifies "displaced populations" as a type of disaster in which the population in concern "leave their homes in groups, usually due to a sudden impact, such as an earthquake or a flood, threat or conflict". The response to the displaced populations -refugees and internally displaced persons- requires "relief operations combined with efforts aiming at collective and lasting solutions" (IFRC, 2013). While the host government is responsible for these populations, UNHCR has the mandate of protection and assistance.
The Arab Spring -popular revolutionary movements against the regimes of some Middle Eastern and North African countries began in 2010- reached Syria in March 2011. The uprising escalated into a civil war in the following months, causing the death of more than 100,000 people. The number of Syrians in need of humanitarian assistance is estimated to be 9,3 million as of November 2013 (ECHO, 2013), 6,5 million of Syrians have become displaced within their country and more than 2 million have crossed the borders to Lebanon, Jordan, Turkey, Iraq and Egypt in search of safety (ECHO, 2013).
Sharing a border with Syria and maintaining an open-border policy since the beginning of the conflict, Turkey jumped from being the 59th most important refugee-hosting country to the 10th in a matter of one year, according to a study by the U.N. refugee agency (UNHCR, 2013). Having registered more than half a million refugees, with the estimated number of 660,000 refugees expected to reach 1 million by the end of the 2013, Turkey is facing the largest mass influx crisis in its history (UNHCR, 2013; UNHCR 15.11.2013 Daily Sitrep, 2013).
2. History of the Mass Influx
Turkey has been a country of mass influxes throughout its history, before and after the establishment of the Republic of Turkey in 1923. The country continues to face the risk of hosting displaced populations for several geographical, political, and social reasons. First of all, Turkey is located between Asia and Europe, acts as a bridge for
3 Emergency and Disaster Reports 2014; 1 (2): 2-53 those leaving their countries in Asia and Africa and leading to Europe in hope of a better life. The mountainous borders in the east and long coasts with Mediterranean and Aegean Seas in the south and west are hard to control, providing entrance points for the asylum seekers.
Figure 1: The map of Turkey
The political instability, namely wars, civil strives, and ethnic and religious oppressions have been common in the Middle East and the Balkans. Turkey, a relatively more stable country in the region, is a close and safe destination for people escaping violence and oppression. Lastly, the family and ethnic links between Turkey and its neighbors create a sense of solidarity in times of hardship (Dilek, 2002).
The types of mass influx into Turkey can be divided into two groups:
1- Immigration of ethnic Turks from Balkans
2- Influx of other ethnic groups affected by war
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Table 1. The mass influx into Turkey by the date, the country of origin, and the number of people.
2.1 Immigration of Turks from Balkans
The first mass influx in Turkish history happened following the Convention concerning the Exchange of Greek and Turkish Populations and Protocol signed at Lausanne on 30 January 1923 between newly established Republic of Turkey and Greece (Arı, 1991). According to the convention, the Turkish-Muslims in Greece Turkey and the Greek-Orthodoxs in Turkey were forced to leave to Greece, despite the fact that these people had settled in these regions for centuries during the rule of the Ottoman Empire. Within two years, 456,851 Turks from Greece arrived in the country, (Akgündüz, 1988) while around 1,5 million Greeks left for Greece (Arı, 1991). A ministry called Exchange, Public Works and Settlement was established to carry out the transportation of the Turks to the country by ferries, to accommodate them in the guesthouses, to facilitate the final settlement, to provide livelihood support, and to help with their social integration (Arı, 1991). They were granted citizenship and usually settled in the houses occupied by the Greeks before the exchange.
Turkey faced another influx in 1950s when neighboring Bulgaria announced that it would expel 250,000 people belonging to the ethnic Turkish minority within three months on 10 August 1950. From the beginning of 1950 to 30 November 1951, a total of 154,393 immigrants (37,351 families) entered Turkey (DPT, 1990). The poor physical conditions of the arrivals due to the harsh treatment in Bulgaria and cold weather triggered empathy, which followed cash and in-kind donations from national and international actors. The government provided shelter, food, and medical care for 12-15 days at the guesthouses set up in the border cities and in Istanbul where the administrative process for immigration and citizenship started (Çolak, 2013). The immigrants were then transferred to their settlement areas according to their
5 Emergency and Disaster Reports 2014; 1 (2): 2-53 occupation and background. The local people and The Immigrant Relief Committees, established under the auspices of President Celal Bayar to coordinate the donations and relief efforts, continued to provide assistance to the settled immigrants. The immigrants received citizenship as the Law on Settlement (No.2510) granted citizenship to ethnic Turks with Turkish culture and language (Dilek, 2002). The provision of housing, cash and in-kind assistance, entrepreneurship loans by the government, as well as the shared ethnicity and language helped the immigrants to integrate into the society.
The oppressive policies of the Bulgarian government towards the ethnic Turks and thus the migration continued in the following years. However, the migration turned into a mass movement when measures such as changing Turkish names to Slavic names, forced displacements within Bulgaria, mass arrests, closing of Turkish schools and mosques, and banning the Turkish traditional practices became unbearable for many. People left on foot, by personal cars, and trains. Turkey received 313,894 people between 26 May-26 August 1989 (DPT, 1990).
The immigrants were accommodated temporarily in the tents established in the border cities of Edirne and Kirklareli, where they were provided food, clothing, and medical care until their immigration applications were completed. They were then sent to temporary accommodations in different cities to stay in their relatives' houses, public guesthouses, rented apartments, or military guesthouses. The government took measures to support the immigrants with food, housing, education, work permits; although the large numbers made it impossible to reach all the immigrants and some decided to return back to Bulgaria. The ones remained were granted citizenship as their predecessors and integrated into the society (DPT, 1990).
In addition to the mentioned Turkish populations, Turkey received immigrants from Yugoslavia and Romania after World War II when the communist regimes used oppressive measures to their Muslim populations. These immigrants were granted citizenship under the Law on Settlement, even though they were not ethnically Turkish as the law required. Between 1946 and 1970, around 182,000 people arrived in Turkey from Yugoslavia (Dilek, 2002).
The migration of Yugoslavians, although slow at rate and would not be considered mass influx, is mentioned here as an example of naturalization of non-Turkish immigrants from non-neighboring countries.
2.2 Temporary Displacement of Populations
Turkey became a transit country for many Iranians fleeing to Europe and North America after the Iranian Revolution of 1979 and during the Iran-Iraq war. As Turkey allowed entry and temporary stay of Iranians without a visa, an estimated 1.5 million people passed through Turkey before resettlement in a third country by the UNHCR
6 Emergency and Disaster Reports 2014; 1 (2): 2-53 between 1980 and 1991. As in the case of Yugoslavia, the steady flow prevented a mass influx, but the large number made it worth mentioning (Mannaert C. , 2003)
Turkey experienced an influx of almost 60,000 Kurdish people across its Iraqi border just after the 8-year-long war between Iraq and Iran ended (Dilek, 2002). On 17th March 1988, Iraqi forces had attacked the Halabja town, a Kurdish populated Iraqi town allied with Iran, with chemical weapons and killed thousands of people. When the war ended couple of months later, Iraq started an assault on Halabja again. Fearing for their lives, thousands of Kurds sought refuge in neighboring Turkey. Initially reluctant to accept them for security reasons as the refugees included Kurdish militias (peshmergas), Turkey felt compelled to open its borders amid growing concerns for the humanitarian situation and increased international pressure. The Turkish government did not recognize them as refugees, which would have given them full protection and certain rights, and instead used terms such as temporary guests, asylum seekers, and peshmergas (Dilek, 2002). Despite the returns after the amnesty announcement by Iraqi government on September 1988, there were 20,000 Kurds on 29 October 1991 living in tent camps in Mardin, Diyarbakir, and Mus (Bruinessen, 1998; TBMM). While Turkish authorities claimed that they had provided food and shelter to the asylum seekers and blamed the Western states for inaction to accept refugees and to share the burden, Turkey was criticized by the human rights groups for not giving the refugees the rights they deserved, the low quality of the housing and police abuse (Dilek, 2002; TBMM).
The second Kurdish influx from North Iraq took place two years later, as Iraqi army lost the Gulf War against the US-led Coalition in the beginning of 1991 and proceeded towards the north to crush the Kurdish uprising started during the war. Around 500,000 people flooded to the border fearing for another chemical attack and killings. Turkish National Security Council decided to close the border on 5 April 1991 in response to the reports suggesting that the number of refugees in the border towns reached 200,000, leaving thousands of refugees stranded at the mountains in the winter with inadequate basic services (Dilek, 2002). While the Turkish government tried to justify this decision by reminding the lack of international support during the influx in 1988 and the security concerns of welcoming large number of Kurdish population (which it saw as a threat to national identity), the domestic discomfort of the local Kurdish population and the pressure from the international community resulted in flexibility. The Turkish government started to lobby for the creation of a "safe zone" in Northern Iraq to enable the repatriation of the Iraqis in Turkey and to prevent the crossing of the others who were stranded at the hard-to-reach mountains. The European Community and the US agreed to create the safe zone above the 36th parallel despite the protest of Iraqi government over territorial integrity (Dilek, 2002). The UNHCR took part in the fast repatriation of the refugees for humanitarian concerns, although it did not approve the highly politicized decision and the compromises made on the fundamental rights of asylum (Long, 2010).
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Although not as large in scale, another influx of people from the West of the country took place around the same time. The first mass influx from that region happened when 20,000 Bosnians fled their country during the civil war in Yugoslavia between 1992 and 1995 (Kirişçi, 2012). They were given temporary asylum and regarded as guests instead of refugees, and many stayed with relatives or in rental apartments while a small portion accommodated in camps and guesthouses in several cities. The camps were established mostly in the border towns and provided shelter, food, health care, and education. (United States Committee for Refugees and Immigrants, 1997) Most Bosnians returned back to Bosnia after the war ended in 1995. Four years later, approximately 17,000 Kosovans entered the country during the Kosovo War (GCIM, 2004). They were also granted temporary asylum, resided in the relatives' homes and guesthouses in the border towns. Majority of them returned after the war.
3. The Legal Aspects related to Mass Influx
Having no specific refugee policy until 1951 except for welcoming ethnic Turks and Muslims from the Balkans based on The 1934 Settlement Law, Turkey signed 1951 Refugee Convention relating to the Status of Refugees with the geographical limitation. Turkey maintained the limitation which would allow it to apply the convention only to the refugees coming from Europe when it signed the Protocol of 31 January 1967 relating to the Status of Refugees (Resmi Gazete, 1994).
1994 Regulation on Asylum Seekers (Law No. 94/6169), amended in 2006, remained the country's only legislation addressing mass influx issue until the National Assembly adopted the Law of Foreigners and International Protection on April 4th, 2013 (Law No. 6458, 2013). The Article 8 of the 1994 Regulation states that the population movements must be prevented at the border with "necessary and effective measures", unless a political decision taken to the contrary (Resmi Gazete, 1994). In case of allowing the mass influx into the country, Turkey provides protection to the displaced populations during their stay. The actions to be taken during the establishment of camps by the Governorates in the areas designated by the Ministry of Interior in coordination with the Turkish General Staff, the separation between the army members and civilians upon arrival, and the interviews and registration of "refugees and asylum seekers" are listed in the Regulation. According to the Regulation, the Governorates where the camps are located shall be responsible for the administration of the camps and the refugees and asylum seekers shall obtain a permit to temporarily leave the camp. The Turkish Red Crescent shall be responsible for the distribution of food and relief items, and shall coordinate with the Ministry of Health for the provision of medical care through the medical cards issued for that purpose. The coordination shall be ensured through the establishment of a committee including the relevant ministries and organizations chaired by the Minister of Interior or a state minister.
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In 1995, Regulation in Respect of Belligerent Foreign Army Members Admitted to Turkey was issued to establish the procedures regarding the protection and services such as food, shelter, and health care of the army members coming to Turkey from a country at war (Regulation, 1995). The main responsibility of protection and camp management in that case lies on the Turkish General Staff in conjunction with the Ministry of National Defense, with the possibility of handing-over the administration of accommodation, food, clothing, and health care to the Turkish Red Crescent Society.
The country's first asylum law, The Law of Foreigners and International Protection (Law No. 6458), developed with UNHCR's technical support and adopted on 4 April 2013, aims to bring the asylum system to international standards in regard to the procedures related to the entry, stay, and exit of the foreigners. The Article 91/1 of the law, which will not come into effect until 12 months after the adoption, states that "Temporary protection may be provided to foreigners who, having been forced to leave their country and cannot return to the country they left, have arrived at or crossed the borders of Turkey in masses seeking emergency and temporary protection" (Law No. 6458, 2013).
Although the definitions and uses vary, the temporary protection is a measure to be applied in case of mass influx into a country that overwhelms the normal asylum system. According to the law, a regulation shall be issued by the Council of Ministers to establish the procedures of entry, stay, and exit of the people under temporary protection as well as their rights and obligations. The measures to be taken against mass movements and the responsibilities of the national and international actors during a crisis shall be addressed in the regulation (Law No. 6458, 2013).
The law maintains the geographical limitations of the Turkish Government under the Geneva Convention regarding the refugee status. While only European citizens can enjoy the refugee status, the people coming from non-European countries may be eligible for conditional refugee status if they are waiting for resettlement in third countries, or may be granted subsidiary protection if the first two statuses do not apply to them. The law guarantees the non-refoulement of these three groups and to the persons under temporary protection (Law No. 6458, 2013).
The duties of The Directorate General for Migration Administration to be established under the Ministry of Interior shall include acting as the secretariat of the Migration Policies Board and carrying out the tasks and procedures related to temporary protection. The Migration Policies Board, consisting of relevant ministries and organizations, is responsible for "identify(ing) the methods and measures to be applied in the event of mass influx, determin (ing) procedures and principles related to foreigners that will be accepted collectively into Turkey due to humanitarian considerations, as well as their entry and stay in Turkey" (Law No. 6458, 2013).
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The refugees and asylum seekers with valid identification documents officially enjoy the same rights with other foreigners staying in Turkey regarding the freedom of religion, the right to seek justice in the court, to marry and to divorce (ACAPS June Report, 2013).
4. Syrian Conflict
The Syrian Arab Republic covers an area of 185,180 sq km in the Middle East (33 30 N, 36 18 E), surrounded by Turkey in the north, Iraq in the east, Jordan in the south, Israel in the southwest, Lebanon and the Mediterranean Sea in the west. The population is estimated to be 22,457,336, with the urban population accounting for the 56.1% of the total population in 2011. The major cities are Aleppo with 2.985 million; capital Damascus with 2.527 million; Homs with 1.276 million; and Hamah with 854,000 residents in 2009 (CIA, 2013).
The ethnic and religious diversity are important factors fueling the conflict. While the Arabs account for the 90.3% of the population ethnically, the rest 9.7% is composed of Kurds, Armenians, and others. As for the religious affiliation, the majority of Syrians are Sunni Muslim with a ratio of 74%, 16% of Syrians follow other Muslim sects such as Alawites and Druzes, and the Christians are 10% of the population. The World Bank categorizes country as a lower middle income country, with the GDP of $73.67 billion in 2012 (The World Bank, 2013). In terms of administration, Syria has 14 governorates, each then divided into districts and sub-districts (CIA, 2013).
The unrest in Syria started in March 2011 in the southern town of Dara'a after the government arrested and tortured some teenagers for writing an anti-government graffiti inspired by the ongoing Arab Spring in the Middle East and North Africa. The angry residents who took to the streets to protest the arrests and the authoritarian regime of the Baath Party led by the president Bashar al-Assad across the country met with violent crackdown from the government. Despite the announcement of lifting the long-lasting state of emergency law and some reforms, the army continued to attack the cities and protestors.
An opposition council called Syrian National Council (SNC) was founded on September 15th to coordinate the policies. The protestors started to take up arms by time and the army defectors formed the Free Syrian Army (FSA) on July 2011 to fight against the regime (Haşimi, 2013 ). The violence between the regime forces and the opposition escalated and spread across the country, although the conflict was not declared as civil war by the International Committee of the Red Cross (ICRC) by July 2012 (Nebehay, 2012).
The opposition gained control of the areas in the North-west and North Syria close to the Turkish border including several border crossings by the fall of 2012 (Sabah, 2012). The Syrian Kurds, populating the North-eastern Syria and staying largely
10 Emergency and Disaster Reports 2014; 1 (2): 2-53 neutral in the beginning, have been fighting against the regime forces and the opposition forces for control of the area since November 2012 (al-Shishani, 2013). While the clashes in the north Syria between the regime and the opposition still goes on with differing intensity, the opposition divided among themselves and clashes between different opposition factors have been taking place.
The international community failed to reach a consensus over the action to stop the bloodshed since the beginning of the uprising. Russia and China, strong supporters of the Syrian regime, vetoed three draft resolutions so far at the UN Security Council. The European Union, the United States, the Arab League and Turkey imposed sanctions early on. The Arab League suspended Syria's membership on November 2011 following a failed peace initiative. The UN-Arab League Joint Special Envoy Kofi Annan worked from February 2012 to August 2012 to meditate a peace process and resigned after the government failed to implement what became known as his six- point plan (Security Council Report) .UN Security Council then appointed Lakhdar Brahimi as the special envoy, who has been working to convince the parties for a conference in Geneva. The chemical attack that killed hundreds of civilians in Damascus suburb Gouta on August 21st, 2013 caused international condemnation, leading to a resolution and authorization of a mission by the UN Security Council for the destruction of the chemical weapons in Syria (Security Council Report).
5. The Refugees
Turkey was the first country to receive Syrian refugees in the beginning of the conflict, with the first group of 252 people crossing the border on 29 April 2011. After two and a half years, Turkey is currently hosting more than half a million refugees (UNHCR 15.11.2013 Daily Sitrep, 2013).
The open-border policy of the Government of Turkey for the refugees passing over six official border crossings as well as a number of unofficial crossings located at the 911 km long border along the plain territory between the two countries; the strong family or ethnic links among people across the border; the ongoing violence in the highly populated North Syria can be listed as the main reasons of the level of influx Turkey is experiencing.
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Figure 2: The number of refugees registered by AFAD as of 15.10.2013. The data is taken from the UNHCR.
The paper is focusing on three groups of displaced Syrians: The first group is the camp residents. Around 200,000 Syrians are being hosted in 21 camps in 10 provinces (UNHCR 15.11.2013 Daily Sitrep, 2013). Majority of the camp residents have been transferred from the official border crossings to the camps directly by the authorities, while a minority have entered the country unofficially and admitted to the camps later on.
The second group of concern is the refugees who crossed the border of Turkey, but living outside of the camps. Amounting more than 300,000, this group includes a small number of official arrivals with passports and a much larger number who used unofficial crossings for entrance. The third group is the internally-displaced persons living at the Syrian side of the border. Around 100,000 people are estimated to be in this group (ACAPS July Report, 2013).
The Prime Minister’s Disaster and Emergency Management Directorate (AFAD) is the responsible body for the coordination of the response to the mass influx crisis (AFAD, 2013).
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Figure 3: The distribution of the registered refugees by cities and location as of 15.10.2013. The data is taken from the UNHCR.
5.1. Displacement into Camps
The first group of Syrians entered Turkey on 29 April 2011. 252 asylum seekers passed through the border on Yayladagi and were taken to a closed sports hall by the local authorities. (Haber7.com, 2011 ) The Syrians were then transferred to the first tent-camp set up by AFAD, The Turkish Red Crescent Society (TRC), and Hatay Governorate on May 1st. TRC provided shelter, food, and basic services to refugees whose number went up to 500 by June with 11 personnel (Türk Kızılayı, 2013). The fist large influx took place on June, when 10,000 Syrians from Idlib governorate fled their homes out of fear of attack by the regime after 120 police officers were killed by army defectors (Aslı Ilgıt, 2013). Four more camps were established in Hatay to accommodate the new arrivals.
The two-way cross border movement kept the total number of refugees stable until the end of 2011; the people came to Turkey during increased insecurity or when needed medical care and returned to their homes when the situation went back to normal. The violence in the country and the influx of the people increased after January. More camps were established in different cities. There were 8 camps by March 2012, the number went up to 13 by September. (Osman Bahadır Dinçer, 2013 ) In the first month of year 2013, a total of 17 camps were hosting around 194,000 Syrians in the cities of Hatay, Kilis, Sanliurfa, Gaziantep, Kahramanmaras, Osmaniye, and Adiyaman (UNHCR, 2013). As of 15 November 2013, 202,297 registered refugees are staying in 21 camps in 10 provinces, including Mardin, Adana, and Malatya in addition to the mentioned cities (UNHCR 15.11.2013 Daily Sitrep, 2013). Apaydin Camp in Hatay is reserved to 4,779 army defectors and their families
13 Emergency and Disaster Reports 2014; 1 (2): 2-53 in accordance with the 1995 Regulation in Respect of Belligerent Foreign Army Members Admitted to Turkey (Regulation, 1995).
Figure 4: The map showing the distribution of the camps in Turkey. Taken from UNHCR monthly summary.
AFAD is responsible for the general camp management. AFAD personnel are working in the region with two-month-long rotations. (Mehmet Güçer, 2013) Being responsible for the provision of food, shelter, non-food items, and logistics in the camps, TRC has field offices for each camp (Türk Kızılayı, 2013).
The governors or sub-governors have their second offices in the camps besides their regular offices (Mehmet Güçer, 2013). Their services include education, water and sanitation, health, and social welfare in the camps. Besides the TRC and the governorates, AFAD partners with the ministries, public institutions, and the gendarmerie to run the camps effectively (AFAD, 2013). The refugee community is involved in the administration through the elected committee of one chief and two members for each designated section of the camps (Mehmet Güçer, 2013). These communities provide a link between the camp authorities and the refugees.
The camps have been praised for the high quality, in terms of the infrastructure and services. The basic services of food, shelter, water, sanitation, and health are incomparably better than the services accustomed in the refugee camps. Education, religious services, recreational areas, telecommunication, and banking are some of the other provisions. Each camp has at least one police station, health facility, school, mosque, market, playground, television room, vocational training center, pressroom,
14 Emergency and Disaster Reports 2014; 1 (2): 2-53 water tank and water treatment center, power distribution unit, and generator (AFAD, 2013).
However, some critics pointed out a number of shortcomings regarding the camps. The first one is that pace of the construction of the camps cannot keep up with the influx of people seeking refuge. As the existing camps are working full capacity, thousands of displaced Syrians are stranded at the Syrian side of the border, waiting for the construction of new camps. The situation is against the adopted open-border policy, according to the human rights groups; while the government insists the Syrians stay at the border by their will (Joe Parkinson, 2012). The IDPs will be discussed in detail in the section 4.4.1.
Another issue raised is the distance between the camps and the borders. While the some later-established camps are more than 50 km away from the border, in line with UNHCR standard for security, the camps established along the border cities at the beginning of the unrest (Altinozu, Yayladagi, Reyhanli, Apaydin, Islahiye ve Ceylanpinar) face security threats due to their close location to Syria (Amnesty International Briefing, 2013).
The third point is that the NGOs and UNHCR were not allowed to visit the camps to observe and monitor the situation in the beginning of the crisis. The Turkish authorities rejected requests on the ground that the visits would violate the privacy, dignity, and possibly security of the refugees. The restriction was relaxed by time, and visitors from UNHCR and NGOs confirmed the quality of the services provided in the camps are way above the international standards (IRIN, 2012).
5.1.1. Status and Protection
While Turkey has kept its border open and did not force the Syrians go back forcefully since the beginning of the unrest, the official declaration of "temporary protection" status to all Syrians came on October 2011 (Osman Bahadır Dinçer, 2013). The status ensures protection "without any specific limit on the duration of stay, with no forced return, and the possibility of obtaining access to assistance" (UNHCR, 2013). The UNHCR, who normally registers the non-European asylum seekers to determine refugee status for resettlement in third countries, suspended individual registration for Syrians after the enforcement of temporary protection status (ACAPS June Report., 2013). The Palestinian refugees who had been living in Syria are also considered under temporary protection, but the status does not apply to other nationals, mainly Iraqi and Somali refugees. They are registered by UNHCR and the Aliens Police for individual refugee status determination (UNHCR, 2013).
As the Syrians under the protection do not meet the criteria to obtain refugee status due to the geographical limitation in the Refugee Convention, the Turkish officials
15 Emergency and Disaster Reports 2014; 1 (2): 2-53 have been careful to use the term "guests" instead of "refugees" to describe them. The UNHCR, NGOs, and the media refers the Syrians as refugees for practicality.
After initial registration at the border, the Syrians are taken to their assigned camps. The police is responsible for the registration of the refugees in the camps and the distribution of the identity cards. Some reluctant to give detailed personal information in the beginning, the refugees have become aware of the importance of the cards to receive assistance. The electronic registration system, first introduced in Kilis Oncupinar camp, expanded to other camps after September 2012 (Elibol, 2012). The system currently covers almost all the camps. The refugees are given their ID cards after their photos and fingerprints are taken with electronic fingerprinting device. The unique chips on the cards allow the police monitor the movement of the person in and out of the camp. The same card is used for service provisions such as health and food.
The registration system remains decentralized; each camp registers and controls the movement of the refugees for that camp. The lack of communication between the camps is misused by some people who can register to multiple camps at once to receive more aid. On top of the economic burden and security problems related to this practice, the exploitation prevents new admissions to the camps by over-stating the number of the refugees in the camps (Mehmet Güçer, 2013). Some Syrians have been unofficially allowed into the camps by the authorities without registration to join relatives. The unregistered population have been estimated to reach 1000-2000 in Oncupinar Camp, officially hosting 13,570 registered refugees (ACAPS October Report, 2013). The registration of these people started recently.
In terms of voluntary returns, AFAD reports that 181,240 Syrians went back to their country by the end of September 2013 (AFAD, 2013). It is not clear if this number represents returnees from the camps or total number of Syrians leaving Turkey.
Turkish authorities repeatedly stated their commitment to the non-refoulement principle when faced with the claims of forced returns. For instance, the Spokesman of the Ministry of Foreign Affairs of Turkey rejected the reports of government sending 500-600 Syrians back to Syria forcefully after a violent protest took place in Akcakale Camp on March 27th, 2013. He stated that after the identification of individuals in a group of 200 people who attacked the security forces on that day, the authorities were about to start prosecution proceedings. These individuals then applied for voluntary return " fearing from the reaction of other Syrians and possible judicial outcomes" (Ministry of Foreign Affairs, 2013).
The UNHCR officers conduct interviews with those who wish to return to ensure the voluntary nature of this request. Upon interviews, they may consult with the Turkish authorities to take possible actions to help the refugees stay as it happened with two Assyrian (Christian) families in Ceylanpinar Camp who wanted to leave because of the camp conditions. After talking to the families and camp officials, the families were
16 Emergency and Disaster Reports 2014; 1 (2): 2-53 transferred to the Midyat Camp hosting the Assyrian Syrians in Mardin (UNHCR 15.11.2013 Daily Sitrep, 2013).
The Government of Turkey is responsible for the protection of the refugees in the camps. Each camp has a police station and some has security cameras around the camp (AFAD, 2013). The police, gendarme, and private security guards work together to maintain the security. The UNHCR provides technical advice and assistance to Turkish government officers, such as trainings on refugee protection to raise awareness and build capacity. Thanks to its offices located in Hatay, Gaziantep, and Sanliurfa, the UNHCR can access all the camps regularly (UNHCR, 2013).
AFAD decided to establish two camps in Mardin for the minority Christian and Kurdish communities fleeing their country upon their request. (Selahattin Erol) The separate camps are expected to prevent possible tension between different groups in a mixed camp. The refugees are free to practice their religion and culture in these camps.
The vulnerable groups are of special consideration. The Syrian children enjoy the national protection mechanisms of the Ministry of Family and Social Policy (MoFSP). The unaccompanied children are being referred to national Child Protection Agency to receive accommodation in the state facilities. UNHCR and UNICEF are collaborating with the Turkish authorities for the issues concerning the protection of the unaccompanied children and the early marriage (UNHCR, 2013).
The Ministry of Heath monitors the domestic violence through daily visits of tents by midwives and social workers (WHO, 2012). The collaboration between Turkish authorities and the UNHCR includes the sexual and gender-based violence (SGBV). The UNHCR shares its expertise on the issue and provides guidelines to apply the national legislation and referral systems for prevention and response of SGBV (UNHCR, 2013).
Following the news of rape and poor treatment of the refugees in Yayladagi and Altinozu camps by the Syrian State news agency, The Human Rights Inquiry Committee of National Assembly conducted an investigation in the camps and found the allegations groundless (TBMM İHİK, 2012).
Despite the involvement of the UNHCR, resettlement of the vulnerable groups with urgent protection needs still remains a challenge due to the "the lack of a unified registration database and the limited information collected at registration" (UNHCR, 2013).
An issue brought up by the refugees and human rights group is the restriction of the movement of the camp residents. Although the movement was restricted at the start of the crisis, the Syrians in the Hatay camps were normally allowed to go out of the camps during the day if accompanied with the camp officers (TBMM İHİK, 2012). They could not leave the camps to settle in the cities by themselves in accordance
17 Emergency and Disaster Reports 2014; 1 (2): 2-53 with the national regulations. Reports by the international agencies reaffirmed the day-time outings of the camp residents. (WHO, 2012 ) The daily permissions may be suspended temporarily for security reasons (UNHCR 17.05.2013 Daily Sitrep, 2013). Some camps issue ID cards to refugees who want to work as daily workers in the towns (UNHCR 28.05.2013 Daily Sitrep, 2013).
5.1.2. Shelter and NFIs
The TRC is responsible for the provision of the shelter in fourteen tent-cities. The establishment of six container-cities were contracted to the Prime Ministry's Housing Development Administration by AFAD (T.C. Başbakanlık TOKİ). The NFI distributions are carried out by TRC in all camps.
Starting with 58 tents set up by the TRC for 252 Syrians who crossed the border on 29 April 2011, 26,928 tents and 11,893 containers (with two room and a bathroom) have been utilized to accommodate 200,034 refugees in the camps as of 26 September 2013 (Türk Kızılayı, 2013).
Besides the accommodation of the refugees, tents for schools, mosques, and recreational areas are provided and maintained by the TRC. The emergency stocks of the TRC were used for the provision of tents in the beginning of the movement. When the number of refugees escalated to 24,281 on April of 2012 with a rapid and continuous influx from Syria, AFAD delivered an urgent needs list including tents to the TRC, which started the production of 20,000 tents in two factories (Çalık, 2012). By December 2012, 23,000 tents with insulation covers for the winter were sheltering Syrians in 13 camps "in compliance with international standards " and the contingency plan was in place for future needs (Aksu, 2012).
The UNHCR donated 15,4 million dollar on 19 December 2012 to produce 18,500 tents in the factories of the TRC, in addition to its donation of 20,700 tents to that date (Türk Kızılayı, UNHCR, 2012). The tents manufactured were 16 square meter, fire-proof and fit for all seasons. The UNHCR's Syria Regional Response Plan for 2013 estimates the camp residents to reach 300,000 by the end of the year and plans to provide 30,000 additional tents for the new arrivals as well as renewal of worn out tents (UNHCR, 2013).
As can be seen on Table 2, each tent and container accommodate five people on average, respecting the privacy of families. The refugees appreciate the service. A study conducted in the camps on January and February showed that the refugees rated satisfaction with the shelter provision 7,44 out of 10 (Mehmet Güçer, 2013). The proper heating during the winter is believed to positively impact the satisfaction. When asked the best service in the camp, 7,3 per cent of the refugees answered shelter; while 9,3 per cent said they were not happy with the shelter.
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PROVINCE CAMPS (T=Tent DATE OF NUMBER OF CAMP (Population) C=Container) OPENING TENTS/CONTAINERS POPULATION Altinozu 1 (T) 09.06.2011 259 (Partition) 1,595 Hatay Altinozu 2 (T) 10.06.2011 620 2,669 (1,483,674) Yayladagi 1 (T) 01.05.2011 563 (313 partition) 3,217 Yayladagi 2 (T) 12.07.2011 510 3,529 Apaydin (C) 09.10.2011 1,165 4,779 Reyhanli (TAC) Changing Gaziantep Islahiye (T) 17.03.2012 1,754 9,392 (1,799,558) Karkamis (T) 28.08.2012 1,636 7,366 Nizip 1 (T) 03.10.2012 1,858 11,196 Nizip 2 (C) 11.02.2012 1,000 5,138 Kilis Oncupinar (C) 17.03.2012 2,053 13,570 (124,320) Elbeyli Besiriye (C) 03.06.2013 3,592 17,210 Sanliurfa Ceylanpİnar (T) 01.03.2012 4,771 27,229 (1,762,075) Akcakale (T) 06.07.2012 5,046 26,364 Harran (C) 13.01.2013 2,000 13,540 Kahramanmaras Central (T) 01.09.2012 2,737 14,986 (1,063,174) Osmaniye Cevdetiye (T) 09.09.2012 2,012 8,515 (492,135) Adiyaman Central (T) 22.09.2012 2,292 9,998 (595,261) Adana Saricam (T) 28.01.2013 2,142 10,189 (2,125,635) Mardin Midyat (T) 19.06.2013 1,300 2,366 (773,026) Malatya Beydagi (C) 12.06.2013 2,083 6,551 (762,366)
Table 2: The situation of camps by the number of residents and shelter. The data is taken from AFAD and TUİK.
The preparation of the tents to winter has been important since most of the camps are located in the areas experiencing cold weather conditions. The preparedness includes replacement of worn out tents, immobilization of tarpaulins against rains and cold over the tents, and distribution of electric heaters and blankets. There has been a case where the electric heaters were collected back due to some power- supply problems (WHO, 2012).
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One problem during the winter has been the fires erupted in the tents. The fires caused by fallen electric-heaters cost the lives of 16 refugees so far. While most of the camps use fire-proof tents, the large needs made the utilization of non-proof tents unavoidable. The authorities have been working on to replace these tents with the fire-proof ones, while constantly warning the families to be careful and not to leave their children alone. (Mehmet Güçer, 2013) Fire extinguishers and fire trucks are available in the camps and the timely response prevented any large-scale fires, but the deaths in the household fires sometimes stirred tension between the refugees and the camp management (Ali Leylak, 2013).
The Turkish Red Crescent is also responsible for the distribution of non-food items in the camps and were reported to cover the basic needs effectively. The distributed NFIs includes blankets, electric heaters, electric stoves, kitchen sets, clothing, winter sets, mattresses and hygiene items. TRC has accepted in-kind donations of these items from donors (Türk Kızılayı, 2013).
As the food program allowing refugees cook for themselves started on October 2012, the need for kitchen sets and cooking equipments emerged. By March 2013, 40 per cent of the camp residents have received cooking materials and kitchen sets. The Red Crescent offered kitchen sets and cooking facilities including mini fridges, electric stoves, and cabinets to targeted families in all camps (UNHCR, 2013).
There has been some unfortunate events during the distributions of relief items. In one such case, a group of protestors claimed a clothing distribution did not cover them. Two police and one refugee were injured when they went violent and some police cars were damaged lightly (haberler.com, 2012).
5.1.3. Food
The TRC is the provider of food security in the camps. Hot meal distributions three times a day since the first day of the influx transformed into e-vouchers system in 14 of the camps by the end of September 2013 (Türk Kızılayı, 2013).
The hot meal distributions by the catering companies started in the Yayladagi Camp, the first camp hosting the refugees, and continued as new camps were established. The TRC appointed two experts to monitor quality, amount, and hygiene of the food during the preparation and distribution. (Türk Kızılayı, 2012) The TRC workers also assessed the cultural preferences of the Syrians early on and requested the catering companies to prepare the meals accordingly. In addition, special food was cooked for diabetic and high cholesterol patients. While the distributions continued three times a day, the refugees sometimes cooked the food they purchased from the local market during the permitted outings (Aktif Haber, 2011).
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The distributions have been carried out at the food distribution units in the camps. In Islahiye Camp, 43 such units had spread across 1,770 tents, meaning 41 families shared one distribution point (Türk Kızılayı, 2012). The hot meal distributions in some of the first established camps in Hatay, namely Altinozu, Apaydin, and Boynuyogun, were replaced by dry ration distributions on June 2012 upon a decision taken by theHatay Governorate. Yayladagi Camp followed on September (Türk Kızılayı, 2012).
The TRC and the World Food Programme (WFP) jointly started an innovative food assistance program on October 2012. The electronic food card system allows the families shop for food of their own taste from the supermarkets and shops. Each family is given one card and 80 lira (45 $) per person is uploaded to the card each month. The amount has been calculated to be sufficient to offer at least 2,100 kcal per person per day as required for a healthy diet (UNHCR, 2013). The card cannot be used to purchase cigarette, alcohol, junk food, and any non-food items to prevent insufficient intake of food.
The programme shared a big burden of the Turkish government, as the costly cooked meal distribution had started to become less and less sustainable with ever- increasing refugees. The WFP and its donors sponsor the cost of this programme. Jean-Yves Lequime, WFP’s emergency coordinator in Turkey, stated that this sustainable and replicable approach could become a model for other refugee programmes in the region (IRIN, 2012). The system first implemented with 13,000 Syrians in Kilis Container Camp, followed by four camps in Hatay. Upon the success of these examples and continuous influx of the Syrians, the government requested WFP to expand the assistance to reach 100,000 refugees by June (UNHCR, 2013). Due to the delay in the establishment of camps with cooking facilities, the system covered less than half of targeted 60,000 refugees by February 2013 (WFP, 2013). As of September, the system has been in place in 14 camps covering 116,000 refugees and is planned to expand to the rest of the camps (UNHCR RRP, 2013).
There has been no studies or reports of malnutrition in the camps. This can be attributed to the uninterrupted provision of the food. The deteriorating situation in Syria with increased reports of rising malnutrition can lead new cases among the new arrivals. 5.1.4. Water and Sanitation
AFAD is responsible for the infrastructure and provision of water and sanitation in the camps. The camps have been reported to have adequate water supply, provided either by connecting the camp water and sewage system to the public water system or by digging boreholes. Water tanks and water treatment systems are also available (AFAD, 2013).
There has been reports of protests in Kilis container camp over the lack of water during the summer of 2012. The authorities argued that the protests were due to the
21 Emergency and Disaster Reports 2014; 1 (2): 2-53 perception of inadequate water, and the water supply was well above the international standards. A water shortage was experienced in the Kilis Elbeyli container site, but the problem was quickly resolved by opening new boreholes on October 2013 (UNHCR 30.10.2013 Daily Sitrep, 2013).
According to a report by the National Assembly's Human Rights Inquiry Committee on February 2012, the water supply was adequate in the Hatay camps and the water quality and chlorination levels were tested regularly (TBMM İHİK, 2012). Latrines, showers, washing machines, and insecticide spraying were available in the camps. The cleaning of public places and waste disposal were managed by the contracted cleaning companies.
When the first camps were established in Hatay, there were seven latrine/shower containers available in the Yayladagi Camp, eight in Altinozu Camp, twenty four in Boynuyogun Camp, and twenty six in the Apaydin Camp (Türk Kızılayı, 2012). Assuming the containers are standard seven-cabinet washrooms used by the TRC, there were one latrine and one shower per seven families in the Yayladagi Camp. Four families shared one toilet/shower in the Altinozu and Apaydin Camps, and the conditions were the best in the Boynuyogun Camp where 3 families used one facility. By September, conditions in all but Apaydin Camp improved due to decreased number of residents or increased number of latrines.
Islahiye Camp, established on April 2012, had 296 toilets, 276 showers, 12 water distribution points, each with 8 taps, 65 washing machine, and 64 dryers on September 2012. A solar panel was established to provide hot water to the refugees, a practice expanded to other camps later on (Türk Kızılayı, 2012).
An UN interagency health assessment mission that was conducted in four tent camps (Islahiye, Nizip, Kahramanmaras, Cevdediye camps) on 4-5 December 2012 concluded that the potable water in these camps were adequate (WHO, 2012). The provision of water was realized by connecting the water distribution points and sewage of the camp to the municipality water system in the camps located close to the cities. The quality of water was tested multiple times a day, and one camp seemed to have particulate matter in the drinking water. In Nizip Camp, even though the drinking water coming from the dam was tested regularly, families with children under four years of age were distributed bottled drinking water. The chlorination level of drinking water -connected to the public system- was tested daily in Kahramanmaras Camp, while biological and chemical tests were running on weekly basis. The test results were shared with the Ministry of Health.
Some of the showers and toilets, constructed in the prefabricated containers, showed damage at the time of the mission's visit and AFAD was working on the repair (WHO, 2012). Daily or weekly waste removal and cleaning activities were run by private contractors, which possibly caused lack of ownership and misuse of the facilities. Hot water for showers, washing machines and dryers were available to the
22 Emergency and Disaster Reports 2014; 1 (2): 2-53 refugees. The recommendation was made on increasing the hygiene promotion activities for adults and children, especially on the hand-washing.
Individual toilets and showers inside the container-houses provide a better standard for those living in the container camps. (T.C. Başbakanlık TOKİ)
5.1.5. Health
The health care services in the camps are fully integrated into the National health care system, including referrals to the public hospitals outside of the camps (WHO, 2012). Routine health screenings are conducted as refugees enter a camp, whether directly from Syria or via transfer from another camp. The Syrians registered in the camps are provided access to all levels of health care services and pharmaceuticals with the same standards as Turkish citizens free of charge from the beginning of the crisis.
Each of the camps has at least one health care facility providing primary health care. Mobile health clinics and field hospitals have been operating in some camps (AFAD, 2013). The health care services were provided by the Health Ministry's Medical Search and Rescue volunteers based on 15-days rotations in the beginning (UMKE, 2012). The MoH later started to appoint the health care providers such as family doctors, specialists, nurses, and auxiliary health workers to the camps. Some camps employ the specialists fully, while they visit some camps several days a week for specialized consultations. (Zaher Sahlool, 2012) There are systems in place for the availability of emergency health services 24/7, either by ambulance or on-call doctors and nurses. The search and rescue teams are still being deployed as needed.
As majority of Turkish health personnel do not speak Arabic, interpreters from the refugee communities facilitate the provision of the services. The language barrier may be an important problem in terms of satisfaction with the services. In October 2013, recognizing this problem and aiming to increase community involvement, Turkish government allowed Syrian doctors to voluntarily work in the Sanliurfa camps after their diplomas were certified by the Chambers of Doctors (UNHCR 10.10.2013 Daily Sitrep, 2013). AFAD states in its website that some of the health teams include Arab doctors, while it is not clear if they are Turkish citizens and appointed by the MoH or volunteering physicians from other nationals (AFAD, 2013).
The health centers in the camps provide consultations (generally 50- 80/day/physician), emergency care, immunization services, antenatal and postnatal care, family planning, and referrals as typical national primary health care centers (Zaher Sahlool, 2012).
The health centers do not experience any drug shortages and effectively provide acute and chronic medicine free of charge. The distribution of the medicine from the
23 Emergency and Disaster Reports 2014; 1 (2): 2-53 health centers in the afternoons or the following day after the consultations were reported in an evaluation of three camps on April 2012 (Zaher Sahlool, 2012). The establishment of a pharmacy was being planned.
Most camps have laboratory services for basic tests, and the samples are sent to more sophisticated laboratories in the cities as needed. On April 2012, 8.2% of the patients were referred and the hospitalization rate was 0.24% for Islahiye and Nizip Camps (Zaher Sahlool, 2012). The referrals to secondary and tertiary levels are generally carried out without any gaps. The capacity of Gaziantep state hospital, which is the tertiary referral hospital for Islahiye, Karkamış and Nizip camps have been extended to 500 beds from 330 bed and 130 medical specialist were added to the personnel to respond to the increased needs and to prevent the disruption of the services to the host community (WHO, 2012). In Kilis, however, the increased workload in the hospital have been reported to affect the quality of the services (Hududeli, 2013).
By July 2013, 1,2 million Syrians received medical consultation in the camp clinics; 200,000 of them were referred for secondary and tertiary care; 24,000 were hospitalized and 15,000 were operated (T.C. Sağlık Bakanlığı, 2013). The free-of- charge services include specialized services such as hemodialysis and cancer treatment. The transportation to the hospitals was facilitated with camp ambulances. In Adiyaman camp, International Organization for Migration (IOM) has been providing transportation since July 2013 (IOM, 2013).
While the acute diseases common in refugee camps such as upper respiratory infections, diarrhea, conjunctivitis, hepatitis A and B, and skin rashes have been prevalent, the most encountered chronic diseases has been recorded as hypertension, ischemic heart disease, diabetes, chronic obstructive lung disease, asthma, and arthritis (Nora Alghothani, 2012).
The pregnant women are registered for antenatal care in the camp health facility, which includes controls by doctors and iron, vitamin D and vitamin A supplementations. All of the 6,051 deliveries conducted by September 2013 have been carried out in the hospitals (AFAD, 2013). After the regular health screening of the newborn, the health of the baby and mother is monitored. The baby is registered for regular vaccination, breast-feeding is promoted, and later milk and infant formulas are provided (Avcı, 2013).
Although there was an attempt to continue Syrian vaccination schedule by the Turkish authorities initially, the Turkish vaccination schedule is being implemented in the camps. In April 2012, measles vaccination coverage was 95 % for children under the age of 18 for three of the camps (Nora Alghothani, 2012). The vaccination of the under five-year-olds with measles and polio as part of elimination programs and catch-up campaigns were carried out in several camps in early 2012, as reported by an inter-agency needs assessment mission (WHO, 2012). Furthermore, children less
24 Emergency and Disaster Reports 2014; 1 (2): 2-53 than 15 years old were administered MMR (measles, mumps, rubella) and OPV vaccination. The immunization against hepatitis A was started by the MoH where diagnosed cases increased the outbreak risk. Mass chickenpox vaccination was being considered as the number of reported cases had increased. The confirmation of polio in Syria, the first outbreak since 1999, by WHO on 29 October 2013 alarmed the authorities and children under five years received a booster dose of polio vaccination (ECHO, 2013).
The early warning system is "mostly event-based and case-based" where all the data from the clinic and health-related sectors are assessed and shared with the authorities (WHO, 2012). The Ministry of Health is responsible to take measures in case of detection of any public health problem.
As the people went through traumatic experiences, psychiatric conditions such as somatoform disorders, depression, anxiety and post-traumatic stress disorder emerged in the early stages of the displacement. The Red Crescent has been providing psychosocial support services for children and women including games and activities since the beginning of the crisis. The vocational trainings such as sewing, hairdressing, crafting are also believed to help the women in this regard (Aksu, 2012). The curative services are not free of problems. Although psychologists and psychiatrists are available in the camps, the language barrier limits the benefit. The lack of understanding of psychological problems and seeking assistance further prevents the utilization of services (Nora Alghothani, 2012). The lack of community involvement in daily service provisions may adversely affect the people's mental health as they feel unproductive. In some camps, refugees are employed as teachers and interpreters, or join the aid distributions (WHO, 2012). The counseling services for the children and adolescents do not meet the need. Psychosocial support for SGBV victims was also reported to be inadequate (ACAPS May Report, 2013). Active case-findings are not conducted.
Although not life-threatening, the outbreak of cutaneous leishmaniasis in Syria, a skin disease transmitted through sand fly, affected a large number of people in the camps. Several thousands of cases were treated in the camps and hospitals (Blaser, 2013).
5.1.6. Education
The primary and secondary schools as well as kindergartens provide education to the refugee children, which consist of half of the camp residents (UNHCR RRP, 2012). The total number of students went up to 45.696 by the end of September from 26,315 in February of the same year (AFAD, 2013; Ministry of Foreign Affairs, 2013). The number of classrooms almost doubled in the same period, from 372 to 693. The high number of students and limited number of classrooms were reported to cause overcrowding (ACAPS October Report, 2013).
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The schools adapt the Syrian curriculum and most of the teachers are volunteer refugees. The Ministry of National Education (MoNE) and UNICEF jointly had a training project for the teachers in the summer of 2013 to improve the quality of the education (Aktuğ, 2013). The UNICEF has been supporting the education of the children in the camps, mainly through provision of materials such as tents, furniture, and educational kits. The provision of shoes and winter clothing are among the activities to improve school attendance (UNHCR RRP, 2012). The accreditation of the education in the camps began to pose a problem as the situation prolongs. Even though the schools are managed by Turkish authorities, the curriculum have not been recognized by Turkey (Selin Yildiz Nielsen, 2013). With years passing by away from home, the possibility of integration comes into question. The lack of recognition may raise problems in case of an integration into the education system, as well as the language of the education. What may be considered as a step for integration, the government allowed the eligible students to register to Turkish universities without paying fees starting from March 2013 (UNHCR Story, 2013). The students meeting the criteria will have access to education, dormitory, and monthly scholarship. 600 students have applied for the following semester (Özer, 2013). Turkish language classes started in the camps to prepare the students for the university (Cihan News Agency, 2013).
Education activities also cover the adults. The Foreign Minister Ahmet Davutoglu stated that by February 2013, 24,370 Syrians received technical training (Ministry of Foreign Affairs, 2013).
5.2. Urban Refugees
Since the beginning of the influx, some Syrians crossing the border have stayed outside of the camps. These included the Syrians with passports who does not need a visa up to three months thanks to an earlier bilateral agreement between Syria and Turkey as well as Syrians using the long and porous border to illegally enter the country. While a smaller proportion live outside the camps because the camps are full and cannot accept them, the majority of the Syrians prefer to reside in the urban areas for political, security, and privacy related reasons as well as due to the restriction of movement in the camps (Yılmaz, 2013).
In the beginning of the large influx, a small number of Syrians crossed the barbed wire along the border to stay with their relatives in the border villages (Aslı Ilgıt, 2013, p. 34). The number grew rapidly as the violence escalated, passing an estimated 460,000 as of 15 November 2013 (UNHCR 15.11.2013 Daily Sitrep, 2013). The refugees now reside in big cities like Istanbul and Izmir as well as the border towns.
The border always remained open for the passport holders, but the government restricted the legal entrance of Syrians without passports. As in practice "open-
26 Emergency and Disaster Reports 2014; 1 (2): 2-53 border policy" meant that the people without documentation should be taken to the camps, the growing number of people and lack of space in the camps stranded many on the Syrian border waiting for establishment of new camps in the summer of 2012 (Osman Bahadır Dinçer, 2013). The temporary border closings also took place for security reasons, the authorities restricted the movement across the border after the explosions at Ceylanpinar border or after the clashes between different opposition groups in Al-Hasakeh and Azaz towns (ACAPS October Report, 2013).
A large number of Syrians looked for other options for reaching Turkey in the face of increased violence, depletion of or limited access to resources, and cold weather during the winter. Many used the unofficial yet tolerated crossings along the border to enter the country. As the Turkish authorities increased the control for both official and unofficial borders mainly due to security concerns, the Syrians increasingly turned to the smugglers, paying them a small sum to cross the border. The smuggling of goods and people have always been a common practice between two countries, the war and restrictions simply increased the incidents (Osman Bahadır Dinçer, 2013).
As the clashes in the North-Eastern Syria increasingly affected the border towns, Turkey decided to build a two-meter high wall along part of the border to prevent the illegal crossings and bullets falling to Turkish side. The construction started between Turkey's Nusaybin town and mainly-Kurdish Syrian town Qamisli. Some media reports claimed the government was trying to separate the Syrian Kurds from Turkey by building the wall, an allegation denied by the Coordinator Governor stating that the aim of the wall was security and prevention of illegal crossings (Baş, 2013).
AFAD started registering the urban refugees on January 2013. The ongoing registration is expected to improve the understanding of the number, location, and needs of the Syrians living in urban and rural areas. In the beginning of the 2013, when the registration started, the estimation for the number of unregistered refugees ranged between 60,000 to 100,000 (STL January, 2013; ACAPS January Report, 2013). The registration process revealed that the number was much higher. Due to the continuous influx, the non-camp refugees have outnumbered the camp residents.
Most urban refugees preferred to stay in the border towns of Gaziantep, Hatay, Kilis, and Sanliurfa beginning, where they have family links and can go back and forth between two countries. As of August 2013, 75 % of the refugees were living out of the camps in Gaziantep and Hatay, the proportion reached 90 % in Mardin, and 49 % in Kilis. Sanliurfa has been an exception with 71 % residing in the camps (ACAPS August Report, 2013).
While still not registered by the authorities, the number of Syrians in Istanbul is estimated to be around 80,000 as of September 2013 (ACAPS September Report, 2013). The districts of Fatih, Esenler, Zeytinburnu, Bayrampasa, Gaziosmanpasa,
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Bagcilar, Basaksehir, Kucukcekmece, Bahcelievler, Esenyurt, and Umraniye have been reported to host high concentrations of Syrians (Yılmaz, 2013).
5.2.1.Status and Protection
Once they cross the border of Turkey, legally and illegally alike, the Syrians become under the temporary protection policy declared by the government on October 2011. The implementation of the status to each group is still unclear to the refugees, to the aid workers, and even to the the government officials, as the content of the directive issued by the government on April 2012 on the application of the policy to different types of the Syrian refugees has not been publicized (RI, 2012). One right all Syrians certainly share is the non-refoulement. Syrians have not been forcefully sent back to Syria. The Syrians entering Turkey without a passport were required to seek shelter in the camps (IRIN, 2012), but many entered unofficially have chosen to stay outside. The authorities tolerate them as the lack of space in the camps to accommodate the large number of Syrians makes it impossible to place everyone in the camps.
The passport owners can cross the border and stay in the country for three months freely. The government issued a directive on 30.03.2012 (No:62), allowing them extend their stay for one year with a temporary residence permit upon the application to the Provincial Security Directorates (Güler, 2013). The Minister of Interior (MoI) stated that 30,106 Syrians were granted the permit by the July of 2013. The officers generally show flexibility when granting the permit, some missing documents do not cause problems. The refugees are given personal ID cards and are able to access the services provided by the government. It is not known how many people entered the country with the passport, but overstaying illegally without extending their passports due to the relatively high cost of application. Even though the permit fee is waived for the Syrians, they still have to pay 200 TL (70 Euro) per person to acquire the permit, an amount not affordable for many Syrians.
The Syrians entering the country illegally remained unregistered until the beginning of 2013. They were tolerated by the authorities and were not deported, but could not access any formal assistance. On January, AFAD and the Gaziantep Governorate started registering these urban refugees in the coordination centers (ACAPS June Report, 2013). The registration later expanded to Sanliurfa, Kilis, and Osmaniye. 313,909 refugees in different cities have been registered as of November 15th, the real number is estimated to be around 460,000. Each coordination center registers the refugees residing in their province.
The registration in Istanbul has not yet started. The donation of 23 mobile registration centers by the UNHCR is expected to speed up the process and cover all the urban and rural refugees (Osman Bahadır Dinçer, 2013). The registration is carried out by taking the personal information, photo, and fingerprint of the refugees.
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The ID card given to the Syrians at the registration allows them to access the government-provided services, including the assistance by the Social Assistance Solidarity Foundation (SSAF) of the MoFSP. The registration do not grant them the right to apply for residency permit or to register with UNHCR for resettlement in a third country (ACAPS June Report, 2013).
The protection of out-camp refugees is not as easy as the camps. Localized hostilities against Syrians have been reported from time to time. In Akcakale, there were protests by the locals following the clashes between Turkish police and some Syrians trying to cross borders (ACAPS May Report, 2013; Sabah, 2013). In Ceylanpinar, some locals allegedly tried to prevent the treatment of an injured Syrian after a Turkish national was killed by a stray bullet coming from Syria (ACAPS July Report, 2013). The Syrians faced the biggest security threat when an explosion in Reyhanli, Hatay killed 45. Many locals blamed the Syrians for the incident. To prevent any backlash, the local authorities transferred all the Syrians living in a public building to the camps, some Syrians left for Gaziantep, and some returned to Syria (ACAPS May Report, 2013; ACAPS June Report, 2013).
The Alawite Syrians have been reported to settle in Istanbul, as they feel safer and have been welcomed mostly by the local Turkish Alawite associations there (ACAPS August Report, 2013).
The specific needs of the vulnerable groups such as unaccompanied children and SGBV victims are largely unknown. The psychosocial support services are reported to be inadequate (ACAPS May Report, 2013).
The UNHCR is consulting with the local authorities and trying to identify the situation with regard to protection issues in the urban areas (UNHCR, 2013).
5.2.2. Livelihood
The temporary residence permit for the passport holders does not allow them work legally. They can apply for a separate work permit after obtaining the residence permit in theory like any foreigner in the country, but the impracticality of it holds many Syrians back. Besides paying $ 700-1000, the Syrians must find an employer to demonstrate that no Turkish citizen is able to fulfill the job requirements (ACAPS June Report, 2013). Naturally, the illegally-entered refugees do not have the right to work.
Some Turkish businessmen have been expressing their willingness to employ Syrians legally in case of an ease in the regulation while the rights groups criticize the incomplete policy that positions the Syrians as regular foreigners (ICG, 2013). The Law on Foreigners and International Protection is expected to speed up the process of obtaining the work permit once it takes effect in 2014.
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Without a legal work to finance the expenses, the refugees have been reported to rely on the remittances from their relatives working abroad, help from the host communities, their savings, selling off their possessions, as well as illegal work (ACAPS July Report, 2013, p. 30). As their stay in the country prolonged, many depleted their savings and their income from the sold assets. The capacity of the host communities also worsened.
The need for cash and the impossibility of legal jobs forced a significant number of Syrians to seek illegal work options, which makes them vulnerable to exploitation by employers in different sectors. In the border towns, the construction and agriculture sectors are hiring Syrians as casual workers. The wages reported are sometimes less than half of what the Turkish workers are paid. Paying as low as 15 Turkish Lira (7 Euro), these jobs are seasonal and irregular in nature. The daily income in reality then becomes even smaller, a family earning less than 6 TL (2,5 Euro) per day on average in Hatay. 84 % of these families were estimated to have no income at all (ACAPS July Report, 2013). The situation in terms of job availability and wage is reported to be better in other cities.
The work opportunities in Istanbul have increasingly attracted many families to move from the border towns. The textile factories, shoe-making shops, and restaurants are common work places for Syrians. The poor conditions such as low wage, long working hours, and child labor have been repeatedly reported as main problems in the textile factories. The wages have decreased as more Syrians arrived and the competition grew in the past year, reportedly from around 850 TL (305 Euro) to 600 TL (215 Euro) in 2013 (Yılmaz, 2013). Children are employed for smaller wages, and more open to exploitation. As the work is illegal and the workers cannot claim their rights, some employers avoid paying the wages agreed. The unregistered refugees are particularly vulnerable, because they are being sent to camps if they are caught by the police. Most illegal workers prefer to stay outside the camps as they need to send money to their families in Syria and they feel the camp environment is restricted. Although the rule of sending them to the camps has not been practiced by the police, the employers feel free to abuse the workers staying illegally knowing that they avoid the police out of fear (IRIN, 2012).
Begging has been adapted as a source of income by some children and women since the beginning of the crisis. The number has increased in Istanbul with the increase in arrivals. There are also men and children selling water, paper tissue etc. by the roads. Increase in prostitution has been reported (ACAPS September Report, 2013).
A number of Syrians have moved to the western towns for seasonal agricultural work (ICG, 2013).
The Syrians with enough capacity started businesses in the country. During the first 7 months of 2013, 122 businesses started in the border towns such as Gaziantep, Mersin and Hatay; the companies established in Istanbul and Bursa in the west
30 Emergency and Disaster Reports 2014; 1 (2): 2-53 counted as 106 for the same period. Some Syrian business owners are working in partnership with Turkish businessmen to avoid the legal problems (Osman Bahadır Dinçer, 2013).
Some Syrians go back to Syria for harvesting, trading, and selling off assets to provide some cash to their families (ACAPS May Report, 2013). The governorates and municipalities, local NGOs, and the Social Assistance and Solidarity Foundation of the MoFSP provide cash assistance to some non-camp residents, the last one by registering the beneficiaries alongside the police (ACAPS July Report, 2013; ACAPS August Report, 2013) .
5.2.3. Shelter and NFIs
While the family ties allowed most Syrians stay in the houses of their relatives in the border towns and villages at the first stages, the growing number required alternative accommodations. Majority of out-camp residents currently rent apartments in the border towns and Istanbul, some take shelter in mosques, sports complexes, and wedding halls, and a minority live in the parks without any shelter except some make-shift tents.
Renting is a challenging option. The prices skyrocketed in the border towns and in the districts of Istanbul with high refugee concentration. The prices doubled and sometimes tripled in the places affected by the influx compared to the prices before the crisis, reaching as high as 1000 TL (360 Euro) in Kilis and 1500 TL (540 Euro) in Istanbul (Osman Bahadır Dinçer, 2013). On average the housing is cheaper in Istanbul, many Syrians pay between 350 - 600 TL (125-215 Euro) (Yılmaz, 2013). The rural areas offer cheaper accommodation. A family can rent a place for 100-200 TL (45-95 Euro) in the villages of Hatay, as opposed to the 350-400 TL they have to pay in the urban areas of the city (STL January, 2013).
The apartments in Istanbul are larger than the ones in the border towns with the same price, a possible pulling factor for Istanbul (ACAPS September Report, 2013). The physical conditions of the apartments generally low standard, the small rooms with inadequate ventilation and heating are used as living room during the day and as bedroom at night. The common dampness of the basement floors, preferred for the low prices, affects the health of the residents negatively. For Istanbul, apartments hosting around 150 families in Kucukkpazar are reported to be the worst. The 8-9 square meter rooms of old commercial buildings without any renting permit are rented to the unregistered families. 10 rooms/families share one bathroom (Yılmaz, 2013). The occupants of these apartments refused the offers by the municipality and NGOs to register them and move them into better shelters.
Some land owners refuse to rent their houses to the Syrians, as they lack a regular income. The deposit and insurance add to the cost of renting an apartment. Facing
31 Emergency and Disaster Reports 2014; 1 (2): 2-53 these challenges, some Syrians share apartments and some rent collective shelters close to the city centers (ACAPS May Report, 2013). Yet some others seek shelter in mosques and other public shelters where they do not have to pay any rent, but have to compromise some basic necessities. Overcrowding, lack of privacy, and lack of sanitation are the biggest problems in these shelters. As many as 40 people share one latrine in these shelters, the use of outdoor toilets without safe excreta disposal, and open defecation were also reported (STL January, 2013; STL February, 2013).
Some Syrians with no financial means stay in the public parks in the border provinces as well as some districts in Istanbul. The number of these people were 4,000 in Kilis on June 2013 (ACAPS July Report, 2013, p. 30). Although 400 of them were taken into Mardin camp in July and some returned back to Syria, the number continued to increase, a worrying trend as the winter comes closer (ACAPS October Report, 2013). Some have erected make-shift tents, while some others simply do not have anything to provide them privacy. They have very little access to sanitation facilities.
AFAD and Kilis Governorate relocated some refugees from the parks and collective shelters to the temporary accommodation centers on November (Governship of Kilis, 2013). In Gaziantep's Islahiye and Nizip towns, all Syrians living in the mosques and parks were transferred to the camps before October due to the cold and rain (ACAPS September Report, 2013). In Reyhanli, Hatay, the governorate opened the doors of the camps to the people without any shelter (ICG, 2013).
The winters have been the hardest times for Syrians outside of the camps. The cold worsens the health problems, such as bronchitis in small children (ACAPS June Report, 2013). The rather manageable number in the previous two years allowed the local people, NGOs, and provincial authorities to reach the refugees for the provision of winter clothing, blankets, heaters, mattresses, and carpets (STL January, 2013). In 2013, the increase in the influx made even enumeration of those in need a challenge for the providers (Mehmet Güçer, 2013). With the registration of the non-camp refugees, the needs assessment and assistance are expected to improve.
While one-time non-food items such as cooking equipment and heaters were generally covered by local people, NGOs, and municipalities, the crucial provision of consumable items such as diapers and hygiene products are not periodic due to lack of funding (Mehmet Güçer, 2013).
5.2.4. Food
At least one Turkish NGO started to provide hot meals from a mobile kitchen for the non-camp refugees on June 2011, when the first big influx occurred (IHH, 2012). Besides local and national NGOs, the municipalities and the governorates carry out meal and dry food distributions. Iftar meals during Ramadan and meat distributions during Eid al-Adha become common by different actors, but fewer organizations
32 Emergency and Disaster Reports 2014; 1 (2): 2-53 provide continuous food support. The refugees can receive assistance from the Social Assistance and Solidarity Foundation of the MoFSP by registering with them (ACAPS August Report, 2013). WFP plans to monitor the food assistance to the urban refugees (WFP , 2013).
Even though the local and national actors try to provide food to the refugees, they cannot reach everyone and provide uninterrupted food aid. Many refugees spend their little money almost entirely on the food. Reducing the meal portions, changing food habits to consume cheaper products, and skipping meals are some of the coping mechanisms adopted by the refugees. 6.5 % of the families were reported to skip meals sometimes for one full day in Sanliurfa, the percentage is higher in other provinces (ACAPS July Report, 2013 ).
The situation is not very alarming, most refugees are reported to have at least two meals a day. Majority of the children are fed three times a day, regardless of the quality of the meal. The baby formulas are also an extra cost for the refugees. The total cost becomes significant when one considers the pregnant and lactating women consist of 7 % non-camp Syrians and the breastfeeding is not a common practice (ACAPS July Report, 2013).
The refugees in the villages have access to cheaper food with better variety than the urban refugees, who struggle to afford the high prices of bread and fresh food (STL January, 2013).
5.2.5. Health
The ambiguity on the access of health care caused confusion for the out-camp Syrians and the health care providers for more than two years. The approach differed from city to city, even within the hospitals depending on the doctor. The circular issued on September 2013 by AFAD covering all the provinces is expected to unify the response (T.C. Başbakanlık AFAD, 2013).
Before the circular, several different health provisions were available for Syrians living in the cities. While some refugees could utilize the camp health facilities in Hatay and Kilis, this service was not made available to urban refugees in Sanliurfa. The access to government-run public hospitals in Hatay and Kilis depended on the capacity and willingness of the hospitals and doctors.
AFAD issued a circular on 18 January 2013, which allowed the public health facilities in 11 provinces with high refugee concentration (Hatay, Osmaniye, Kilis, Kahramanmaras, Gaziantep, Sanliurfa, Adıyaman, Adana, Mersin, Malatya, and Batman) to treat the registered non-camp patients free of charge and refer them for more specialized care according to national referral system (T.C. Başbakanlık AFAD, 2013). The circular requested the invoices to be sent to the Governorate's Provincial
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Disaster and Emergency Directorate where the refugee is registered. In case of unregistered refugees, the hospitals were requested to contact the Provincial Disaster and Emergency Directorate working 24/7, so that a parallel registration by the hospital and AFAD could take place. Even though some reports suggested access to tertiary health care and follow-up services were unavailable in some cities, the circular guarantees the access to health care in general (Osman Bahadır Dinçer, 2013 , p. 35). The health facilities and health care workers are overwhelmed with the high numbers in the border provinces, and plans to improve the capacity are underway (Amnesty International Briefing, 2013).
The restriction of the circular to 11 border provinces prevented Syrians living in other cities from utilizing the public health care system. This was especially a big problem in Istanbul. While the primary health care for common illnesses could be accessed depending on the willingness of the doctor and the facility, chronic diseases, deliveries, antenatal and postnatal care, vaccination, and surgical operations overwhelmed the Syrians in need of these services (Yılmaz, 2013). Many hospitals rejected admission of Syrians without payment and some refugees were held in the hospital for their unpaid bills after the operations. AFAD expanded the circular on the health care to 81 provinces on September 2013, covering all the refugees. In practice, some hospitals were reported to charge the refugees either because they did not know the circular or refused to follow it (Osman Bahadır Dinçer, 2013). The expansion of the services are expected to solve the problem of inadequate immunization coverage.
Besides the public health facilities, the refugees can access free health care in the Syrian-run health centers, which are unregistered yet are tolerated by Turkish authorities. The financing of these centers run by the volunteer Syrian health professionals come largely from private Syrian and international donors, they are also get some support from Turkish NGOs and local people. The knowledge of the refugees about these services and their quality were questioned by some critics. The lack of medicine was reported to be a problem for these clinics, as well as for the clinics run by several Turkish NGOs.
Although the access to the health care facilities are guaranteed with the circular, more needs to be done for the access to the medicine, one of the biggest health problems. The drugs for the chronic diseases were of special concern. The circular suggests the provision of medicine, glasses, prosthesis teeth, and hearing devices in accordance with national Health Care Directive, which does not cover all the expenses (T.C. Başbakanlık AFAD, 2013). The Sanliurfa Pharmacy Union and the Provincial Disaster and Emergency Directorate agreed that the refugees will pay only 20 % of the cost for the medicine (ACAPS July Report, 2013). The Turkish Pharmacy Union and AFAD are working on a standardization procedure, which will allow the refugees to access free medicine. The expense will be covered by the Provincial AFADs (Zaman, 2013).
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The ambulances at the borders transfer the wounded civilians and fighters brought to the border by Syrian ambulances and private cars to the public hospitals where they receive the first treatment including surgical operations, the serious cases are then referred to more specialized hospitals (Doğan News Agency, 2013). There are also some hospitals established jointly by international and Syrian NGOs providing surgical care. Because the hospitals do not have capacity for post-operational care for the large number of the wounded in many cities, the authorities tolerate the Syrian-run and reportedly foreign-financed wounded treatment centers (Osman Bahadır Dinçer, 2013).
The mental health problems are estimated to be high given the traumatic experiences of the refugees and the research done on the camp residents (STL January, 2013). The psychosocial support is insufficiently addressed by some NGOs. (ACAPS July Report, 2013). The language barrier remains to be a problem for the Turkish actors providing these services.
As for the communicable diseases, thousands of Syrians living outside of the camps were affected by the leishmaniasis outbreak in Syria. The treatment were provided by public hospitals and Syrian health centers. A leishmaniasis clinic was established in Gaziantep to treat the patients. While Turkish doctors treated 10,000 cases Gaziantep and Kilis during the summer of 2013, while many refugees visited Syrian clinics which started to struggle with the large numbers and lack of medicine (Blaser, 2013). The case treatments and insecticide sprayings keep the situation under control.
The polio outbreak inside Syria alarmed the Turkish health authorities. The mass vaccination of all children under 5 year old in the border provinces and all the refugee children elsewhere is planned to start with the support of WHO (WHO Europe, 2013).
The Coordinator Governor Veysel Dalmaz told the press on November 9th that the MoH is vaccinating every child coming from Syria against measles, polio, and leishmaniasis. He also said that Turkey will support the mass vaccination over the border (Baş, 2013).
5.2.6. Education
The children consist of the largest age group among the refugees. Children under the age of 16 are estimated to account for 39-44% of Syrians living outside of camps. Only 20 % of the school-aged children are believed to be in either school or some educational facility (ACAPS July Report, 2013). While the children who are registered with their passports have been eligible for primary and secondary education by law, the rest of the children lack that opportunity. Some schools have accepted the second group as guest students, meaning they can follow the lessons without receiving a certificate. The main difficulties the children face are the language barrier
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(except Syrian Turkmens), differences in curriculum, and transportation to the schools. Even if the attendance rate is low due to the mentioned difficulties, some schools could not accept the increasing number of children because they lacked classrooms and teachers (UNHCR, 2013). Many Syrians move to Istanbul from the Southern cities as the access to education is considered easier there. (ACAPS September Report, 2013) Unregistered children can attend the classes in some camp schools in Yayladagi, Hatay. Lack of transportation from far villages prevent children living in the rural areas from using that service (STL January, 2013).
Some unofficial schools have been established by Syrians to overcome the difficulties with the Turkish schools. These schools provide education in Arabic following the Syrian curriculum with Syrian volunteer teachers. The certificates and diplomas are not recognized by Turkey, and the accreditation in Syria will remain a question. The schools get some support from Turkish authorities and NGOs. For instance, 2,500 children receive primary education in three buildings provided by the municipality in Kilis. A number of organizations donated school materials and the authorities gave permission the International Medical Corps to carry out trauma counseling for students. (UNHCR News Stories, 2013) As of November 2013, there exist 55 such schools in the border towns and Istanbul (Osman Bahadır Dinçer, 2013).
The Turkish courses for children and adults by NGOs have started in the border cities. The refugees did not make an effort to learn Turkish nor wanted their children to go to Turkish schools in the begenning as they believed they would return back to their country soon. After two years of war with no peace in sight, many changed their mind. While the learning of the language is useful for integration with the Turkish society, some questions have been raised regarding problems the children will face when they return to Syria after war (Osman Bahadır Dinçer, 2013).
AFAD is trying to assess the access to education for refugee children living out of the camps. With the registration of the urban refugees are ongoing, the Turkish authorities, UNHCR, and UNICEF are working on the solution of the education problem which may include the use of the Syrian curriculum and certification (UNHCR, 2013).
5.3. IDPs in the Northern Syria
As early as March 2012, Turkish Prime Minister Recep Tayyip Erdogan called the UN to establish a safe haven/ buffer zone inside Syria to allow the Syrians to access humanitarian aid without crossing the border (Aslı Ilgıt, 2013). Turkey repeated this request in different settings in vain. Although Turkey could not convince the international community for an official buffer zone, the developments in the Syrian- Turkish border created a de facto one.
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Although Turkey adopted an open-border policy since the beginning of the influx, the gates were not open to all at all times. While allowing the passport holders enter the country freely and settle wherever they want, Turkey accepted the Syrians without passports officially when there is space in the camps to accommodate them. The pace of construction of new camps kept up with the arrivals by the end of summer in 2012. The camps have become unable to respond to the high influx which started the late summer. While the construction of new camps were underway, the Syrians were stranded on the Syrian side of the border. They started to set up make-shift tents at the border - where they were protected from the bombs and airstrikes- with the hope of entering Turkey soon. Whenever a group was taken to Turkey to be placed in a newly-established camp by AFAD, they would be replaced by new arrivals. The number grew continuously, reaching to 45,000 on February 2013 from 15,000 on October 2012 (WFP , 2013). Even though people know they will not cross the border, the border region is considered safer. Parts of the border between the two countries have turned into a de facto buffer zone with an estimated 100,000 people taking refuge by July 2013 (ACAPS July Report, 2013). Of the 16 different IDP camps, 14 are in Idlib governorate, 2 are in Aleppo, and Lattakia is hosting 1 camp.
Facing accusations from human-rights groups for preventing the asylum seekers from entering the country, the Turkish officials stated that these people prefer to stay at the Syrian side as they knew the camps were not ready to host them and all will be welcomed if there is any immediate threat on their security. The statements proved to be implemented in the summer of 2013. Turkey allowed 3,000 Syrians enter at once when the fighting between Syrian Kurds and Jihadist groups in Tel Abyad and Ras al-Ain threatened the civilians, the entries from Akçakale and Ceylanpinar camps went up to 1,500 people daily (ACAPS September Report, 2013).
Turkey and Syrian opposition are in favor of keeping humanitarian operations inside Syria as much as possible. Turkey officially cannot conduct cross-border operations as it would breach the sovereignty of the Syrian state, so adopted what it calls a "zero- point aid delivery" at the border in the summer of 2012 (Osman Bahadır Dinçer, 2013). In this system, the aid from Turkey is delivered to the buffer zone at the border, where it is transferred to the local organizations to be distributed inside Syria. The main actors doing the zero-point aid from the Turkish side have been the TRC and IHH, the biggest Turkish NGO. While TRC usually delivers the aid from AFAD, IHH's aid is generally sponsored by private donors and partner organizations. AFAD spent $ 128 million in two years for the IDP camps. IHH has access to deeper areas within Syria through its local partners (ICG, 2013).
To finance the cost of aid to Syria, and to a lesser extent to Jordan and Lebanon, AFAD, TRC, and Turkish Diyanet Foundation, along with Turkish NGOs, trade unions, and media launched a campaign called "Bread and Blanket for Syria" on December 2012 (breadforsyria.com). The donations to AFAD, RC, and TDF passes 7 million Euro in three months. (haberler.com, 2013) The aid covers the areas of shelter (tents, blankets, clothing), food (cooked meals, bread , flour, food parcels), health (medicine,
37 Emergency and Disaster Reports 2014; 1 (2): 2-53 medical equipment, ambulances, mobile clinics) and water and sanitation (container latrines and showers, hygiene kits) (IHH, 2013).
There are also a number of Syrian-led and international organizations and initiatives providing aid to inside Syria passing through the Turkish border, although some INGO complained the lack of clear rules and regulations prevented them from carrying out operations smoothly (ICG, 2013).
It is not clear who -if anyone - is managing the IDP camps and coordinating the aid, explained largely by the secret nature of the assistance and the actors. Many organizations do not publicize their work to be able to reach government-held areas. The Red Crescent states in its report that they deliver the aid to the representatives identified by the Turkish governorates with the international observers (Türk Kızılayı, 2013). A lack of communication between the Turkish authorities/assistance providers and Assistance Coordination Unit, the humanitarian wing of the Istanbul-based Syrian National Council, has been reported (Osman Bahadır Dinçer, 2013).
Although the zero-point assistance has been playing an important role for assistance to the Syrians, the coverage and adequacy of the aid in the camps have not been assessed. A joint assessment in the Northern Syria found the needs for food, health, and water and sanitation to be high in the northern governorates hosting IDPs (Joint Rapid Assessment, 2013).
Turkey changed its call for safe haven to cross-border humanitarian aid after the camps are established. While Under-Secretary-General for Humanitarian Affairs and Emergency Relief Coordinator Valeria Amos voiced her support for cross-border aid, no such decision has yet taken by the UN (UNSC, 2013).
The security of the camps becomes the biggest concern as numbers grow. Due to the close proximity of the camps to the Turkish border, the Syrian government air forces cannot reach the area, making IDPs feel safer against the airstrikes. However, the increasing fights between different opposition groups in the nearby towns have been a worrying trend as they can easily spill over to the camps (Osman Bahadır Dinçer, 2013).
6. Effects on the host communities
The Turkish people have welcomed the Syrians fleeing their country with hospitality since the beginning of the influx. The local people and authorities alike have been working day and night to meet the needs of the refugees, hosting them in their homes, collecting and distributing aid, and prioritizing them in the hospitals. Leaving behind the second anniversary of the crisis, Turkish people were affected by the influx in a number of ways and many challenges lay ahead.
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Although not directly related to the influx, but rather to the conflict itself, the security has been a major problem for the people living in the border towns. After a Turkish fighter jet was shot down by Syria in June 2012, Turkey increased the military presence along the border (Aslı Ilgıt, 2013 ) and NATO Patriot air defense missiles were deployed to the border when a bomb from Syria killed 5 in Akcakale town on October 2012 (BBC Türkçe, 2012). Two explosions in Cilvegozu border early in 2013 and another explosion in Reyhanli later on May directly affected the locals, killing tens of people and creating panic across the nation (Osman Bahadır Dinçer, 2013). The fighting between different groups within Syria also posed a security threat to the civilians in Turkey, stray bullets and mortar shells increasingly have made their way across the border, sometimes causing casualties (ACAPS July Report, 2013; ACAPS October Report, 2013; ACAPS August Report, 2013). These incidents frustrated the residents of the border towns, some have moved to safer areas and some protested the local authorities for the lack of security (Öylek, 2012). The authorities increased the security measures in response, including temporary closings of the borders and moving the schools to safer areas (Anadolu Agency, 2013). TRC offered psychosocial support to the citizens in the affected towns (Türk Kızılayı, 2013). The government hopes to reduce these incidents by building a two-meter high wall in parts of the border (Baş, 2013). Following a circular issued by AFAD, the injured people and the vehicles carrying the injured are required to be checked by the police for explosives before proceeding to the Turkish hospitals (Aslandiyarbakır, 2013).
There were some complaints by the residents about the opposition fighters walking around with their guns in public during the first stages of the influx. The authorities increased the security measures to prevent the passing of the guns into Turkey and recruitment of the soldiers from the camps (Osman Bahadır Dinçer, 2013). The Apaydin Camp in Hatay, hosting the army members defected from the Syrian army, has been speculated to be a training camp for the Free Syrian Army. The government denied the claims and allowed a visit by the opposition party (Aslı Ilgıt, 2013).
The conflict and influx caused an economic loss for the border region and the country. The $ 2,3 billion trading volume with Syria in 2010 dropped to half a million in 2012. The situation improved in 2013, the official trade boosted 60 % in the first 7 months, as the needs in Syria continues despite the war and Turkish border is the only access to goods for the opposition-held North Syria (Osman Bahadır Dinçer, 2013). The Turkish vehicles transfer the goods at the border to the trucks of their partner companies. Turkish nationals have been banned from entering Syria by the Turkish government for security reasons. A rather small positive economic impact is the capital brought in by the Syrian businesses/companies opening in different cities, which is estimated to reach 14 million Euro (Osman Bahadır Dinçer, 2013). Another affected group is the smallholder families in the border. Besides the decreased trading with Syria, the insecurity at the border, looting of the irrigation materials, increased life expenses, and the competition for the prices for the goods brought to the market by Syrians returning to Syria and harvesting crops (ACAPS May Report,
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2013). Many also have been hosting refugee families, increasing the daily expenses. The ministry of Food, Agriculture and Livestock, along with UN Food and Agriculture Organization (FAO), started a project to recover the economic loss of the smallholder families with farms within 5 km of the Syrian border (UNHCR, 2013).
Many daily workers in agriculture and construction sectors have been unable to find work as the Syrians offer cheaper labor, while the employers profit from the situation (ACAPS June Report, 2013). Meanwhile, the increase in the food and rent prices affects everyone in the border towns. The most affected are the poorest in the region, whose social assistance by the NGOs and authorities diverted to the Syrians (Osman Bahadır Dinçer, 2013).
The increasing number of urban refugees raised concerns for the demographics of the small cities and towns. Having different ethnicities and sects, Hatay has been watched closely in this issue. The Arab population of Hatay is mainly Alawites, the sect followed by the Syrian regime. The majority of the refugees, on the other hand, are Sunni Arabs. Even though no big scale violence has been reported between the two groups, the tension remains on air. In Kilis, the proportion of Arabs raised to 42 % from 1%, a change did not yet caused any ethnic problem. The flow of the refugees also might change the ethnic balance in Kurdish-Arab mixed provinces such as Sanliurfa and Mardin. The Democratic Union Party (PYD), a Syrian Kurdish group linked to the PKK (a Kurdish organization listed as a terrorist group in Turkey), is fighting for control in the Northeastern Syria. The Turkish officials are worried that the infiltration of PYD into Turkey would cause tensions in these mixed regions and harm the peace process with PKK (Çağatay, 2013).
Working over their capacities for two years, the hospital staff in the border towns have become weary. The capacity improvement is ongoing for the hospitals, but the reluctance of the staff to work in the border towns causes concerns for meeting the needs. (Osman Bahadır Dinçer, 2013 ) Many Turkish patients have been going to different cities for non-emergency operations as the border hospitals treated the wounded from Syria. The leishmaniasis and polio outbreaks in Syria alarmed the Turkish health authorities. The leishmaniasis has been taken under control by treating the cases and mass insecticide- spraying (Adabaş, 2013). Vaccinations against polio in the border towns are being carried out to prevent transmission to the Turkish population (WHO Europe, 2013) The rumors of measles outbreak amid the increased cases were denied by the MoH, which stated an increase in measles cases caused by the European strand (Adabaş, 2013).
A report prepared by a local Kilis initiative provides an insight to the social problems faced by the host communities (Hududeli, 2013). Marriages between married Turkish men and Syrian women, illegal under Turkish law, is one of the problems causing divorces or culturally unaccepted polygamies. Begging, pick pocketing, and fights disturb the peace of the city. The increase in traffic is experienced with many Syrians coming with their cars, the lack of insurance causes problems in case of accidents.
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The capacities of the local authorities are stretched in the small cities and towns where populations sometimes doubled with the influx. The municipalities and governorates have been using their resources to support the refugees, causing discontent for the host communities (Hududeli, 2013). In some towns, the sub- governorate personnel are working double shift to serve the refugees without neglecting the host population (Mehmet Güçer, 2013).
7. Different Actors and Relationships
AFAD has been the main coordinator for all the relief efforts regarding the Syrian influx crisis. AFAD is responsible for the management and allocation of the official funds and donations, the management of the services in the camps, and the registration of the urban refugees, as well as the services provided to them by the government (AFAD, 2013).
AFAD works closely with the provincial governorates and the TRC for the provision of the services in the camps. The government appointed a governor on September 2012 to coordinate the humanitarian operations for the Syrian refugee crisis. (Veysel Dalmaz Profile Page) The relevant ministries have been involved in the sectoral response in the ministerial and provincial level for both camp and non-camp refugees.
AFAD's coordinating role has largely focused on the camps in the beginning, with the local people, governorates, sub-governorates, municipalities, and NGOs provided much of the support -mostly in an uncoordinated manner- to the refugees living outside of the camps. The registration process of these refugees by AFAD and governorates will help better understanding of the situation and will provide a more unified governmental response, starting with the health care. The software called Electronic Aid Distribution System (EYDAS) developed by AFAD aims to coordinate the needs and assistance by the aid providers, mostly by Turkish NGOs.
While the money spent by Turkey to support the refugees by April 2013 has been estimated to reach $ 750 million (ACAPS May Report, 2013), the Prime Minister declared on October that the expenses passed $ 2 billion. The international support covered $ 135 million of that cost (Suriyelilere 2 milyar dolar. Türkiye, 2013 Nov 31). These figures include the assistance to the IDP camps at the Syrian side of the border as well as the camp and urban refugees in Turkey, but does not take into account the relief efforts by the local municipalities.
Turkish authorities, having the capacity to respond to the emergency, did not request any international help for one year from the beginning of the crisis. Facing a growing influx, the government decided to accept critical relief items from the international organizations (UNHCR, 2013). The government also accepted to join the planning of the revision of The Regional Response Plan (RRP) for the second half of the year 2012, the UNHCR's strategic framework of action to address the Syrian refugee crisis in the
41 Emergency and Disaster Reports 2014; 1 (2): 2-53 affected regional countries. The role of the international organizations UNHCR, UNICEF, WHO, WFP, UNFPA and IOM have since been provision relief items to TRC, technical assistance in relevant sectors, and support the projects of the TRC, AFAD, and ministries. The funds collected by November covers only 32 % of the required $ 372,390,514 for RRP's 2013 Turkey budget (UNHCR).
Besides the UN agencies, the IFCR, the governments, National Red Cross and Red Crescent Societies, in a lesser extent, Turkish and international NGOs have been supporting the activities of the TRC in form of cash and in-kind donations. The IFCR launched an appeal on November 2012, revised a year later, and aims to support the TRC with cash, kind and services totaling 44,5 million CHF (36 million Euro) by June 2014 (IFRC, 2013).
The international NGOs have been complaining that they are not able to carry out activities due to the long registration process with the government. As for the camps, Turkish officials argue the centralization of the assistance makes it consistent and manageable, prevents the security problems, and protects the dignity of the refugees. Even with the restrictions, around 40 INGOs work in the border towns and Northern Syria, some tolerated by the authorities without a permit (ICG, 2013).
8. Conclusions
Having hosted millions of displaced people in its history, Turkey generously welcomed the Syrians fleeing the war in their country since April 2011. The country has proven its hospitality to its "guests", the term used by the authorities to describe the displaced Syrians under temporary protection. The guests are likely to stay longer than the host expected given the current stalemate and the level of destruction in Syria. Turkey and the international community need to plan for possible scenarios, addressing the needs of all the affected.
Turkey's AFAD has probably set up the best refugee camps the world ever seen with little support from outside; very few compromises were made for the provision of services. While the good heart and hard work of the Turkish authorities are appreciated, Turkey has to consider the sustainability of the camps for longer periods. The authorities should decide on whether to build more camps for accommodation of the new arrivals or to change the approach to invest more on the services provided to the urban refugees. The camps are costly and slow to respond to the influx, but easier to manage then dispersed urban refugees. The urban refugees are need to be integrated into the Turkish society, which would require time and effort to address the social, linguistic, economic, and security concerns.
The urban refugees, managed in the local level informally by the impressive work of local authorities, people, and NGOs, have already outnumbered the camp residents. The Turkish authorities have taken some action to this change in demographics.
42 Emergency and Disaster Reports 2014; 1 (2): 2-53
Registering the urban refugees is ongoing, free access to national health care started, and some progress has been done in the field education. The comprehensive needs assessment of the urban refugees should be conducted and efforts should be made to effectively cover the needs.
An ambiguous situation of the IDP camps at the border should be resolved as soon as possible. Although the zero-point delivery has been a lifeline for the IDPs, more sustainable and systematic response should be considered prioritizing the security of these people.
The international community should share the burden of Turkey. The promising increase in the financial support and coordination should speed up.
In conclusion, Turkey should continue its appreciated humanitarian assistance to the displaced Syrian population. The efforts should be made to effectively and comprehensively address the needs of refugees in the camps, the urban refugees, and the IDPs at the border. The international community should increase its support to Turkey. The communication between the Turkish authorities and the international actors should be improved.
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